3.1 Tuberculosis Case Definitions

Case definition is necessary for

Correct patient registration and reporting.
Correct choice of appropriate standard regimen.
Patient follow-up.
Cohort analysis including determining trends in the proportions of different types of patients

3.1.1 Bacteriologically confirmed TB case

Bacteriologically confirmed TB case is one from whom a biological specimen is positive by smear microscopy (LED or ZN) or culture (both Liquid & solid) WHO recommended rapid diagnostic (WRD) such as Xpert MTB/RIF, Xpert ULTRA & TrueNat etc. All such cases should be notified, regardless of whether TB treatment has started or not.

3.1.2 Clinically diagnosed TB case

Clinically diagnosed TB case is one who does not fulfill the criteria for bacteriological confirmation but has been diagnosed with active TB by a registered physician based on strong clinical evidence followed by a decision to give the patient a full course of TB treatment. This definition includes cases diagnosed by clinicians on the basis of X-ray abnormalities or suggestive histology and extra-pulmonary cases without bacteriological confirmation. Clinically diagnosed cases subsequently found to be bacteriologically confirmed (before or after starting treatment) should be reclassified as bacteriologically confirmed case.-- Only bacteriologically confirmed or clinically diagnosed patients should be initiated on TB treatment. No patient should be commenced on trial TB treatment.
-- All pulmonary TB cases must have sputum examined for TB by a NTP and WHO recommended diagnostic tool.